Dr. Katherine Chen, a physician earning her doctorate at the UCLA Fielding School of Public Health, has received the Society of General Internal Medicine’s 2022 “Mack Lipkin, Sr. Award” for best scientific presentation by a trainee for her work on the impact of housing costs on renter’s health.
“We know that staying in unaffordable housing is clearly linked to adverse health outcomes, health behaviors, and health care use; and we also know that formal evictions – the majority of which are due to unpaid rent – also contribute to worse health outcomes,” said Chen, who earned her MD at the David Geffen School of Medicine at UCLA and currently holds a primary care research fellowship in the Department of Medicine. “But is moving to try to find cheaper housing and avoid eviction, like 1.8 million renter households do each year in the U.S., any better for health?”
Chen’s past research has been published in the Journal of General Internal Medicine, the official journal of the Society of General Internal Medicine (SGIM), and she presented work from a follow-up study at the Society’s annual meeting in April. Her talk, titled “Cost-Related Residential Moves are Associated with Adverse Health Outcomes and Behaviors Among California’s Renters,” was one of three winning presentations selected from the twelve finalists honored at the conference.
“There has been previous research on the effects of gentrification on health outcomes, but this was the first one that I’m aware of that specifically tested the impact of cost-related housing displacement at the individual-level on health outcomes,” said Dr. Frederick Zimmerman, UCLA Fielding School of Public Health professor of health policy and management and Chen’s advisor. “I was surprised—and dismayed—by how large and robust the findings were. No one would want such adverse health effects for themselves. Public policy should endeavor to ensure that adequate housing is generated for all to achieve stable housing. It’s a real health issue.”
Chen’s research is based on data collected by the California Health Interview Survey (CHIS), conducted by the UCLA Fielding School of Public Health's UCLA Center for Health Policy Research, led by Dr. Ninez Ponce. People who had recently moved due to unaffordable housing, compared to moving for other reasons or not moving, had worse self-rated health, greater psychological distress, and lower odds of finding time for exercise.
“Think of it this way: getting to a medical or dental appointment, or even simply picking up a prescription at the pharmacy, takes time out of the day; now couple that with the stress of dealing with unstable income or an increase in rent plus the disruption of being forced to leave one’s home, one’s routines, and find something better, or at least more affordable,” Chen said. “I have seen in my clinical practice and my research that these issues add up and can be very detrimental to a person’s overall health.”
Based on CHIS data, Chen and her fellow researchers found that:
- Compared to not moving, cost-related moves were associated with adverse health outcomes, behavior, and health care use outcomes, even after adjusting for a long list of sociodemographic covariates. Although the magnitude of these associations was small, the large number of renters affected by and at risk for these moves may make this important at the population scale.
- While all moves can be disruptive, cost-related moves, compared to non-cost-related moves, are particularly associated with worse health outcomes and behavior, while health care use outcomes were similarly bad among both types of moves.
- Black and Hispanic renters were at significantly higher risk for cost-related moves compared to White renters. Racial/ethnic disparities in the prevalence of these moves, which might result from factors like differing economic opportunities and/or discrimination in housing, could represent a mechanism by which structural racism drives health disparities.
Chen has been at UCLA since 2011; she completed an undergraduate degree in molecular cellular and developmental biology at Yale University in 2010, earned her M.D. at the David Geffen School of Medicine at UCLA in 2015, and completed her residency in Internal Medicine at UCLA in 2018, where she was chief resident in 2018-19. Chen completed the National Clinician Scholars Program, also at UCLA, in 2021, and is currently a clinical instructor in the UCLA Department of Medicine and a fellow in the National Research Service Award T32 Primary Care Research Fellowship and the Specialty Training and Advanced Research Program.